This proposal addresses the use of an innovative Health IT application which great potential to improve the efficiency and reach of mental health services to individuals in need by improving the quality and outcomes of care, reducing costs and increasing access to care. This application proposes the use of an innovative, novel technological solution (Asynchronous Telepsychiatry) to mental health care shortages. To assess the impact of this novel approach, this randomized controlled trial of clinical outcomes seeks to evaluate the superiority of asynchronous telepsychiatry (ATP) consultation model on access, quality, cost and outcomes of care over the usual face-to-face telepsychiatry consultation model for adults referred from primary care clinics for psychiatric evaluation and treatment. In this proposed project we will refine the different process and technological approaches that can be used to deliver ATP as part of daily clinical practice, which patient groups find it most useful and effective, and what clinical styles of training and interaction work best with the ATP process. We intend to demonstrate how the health IT system, ATP, can better support clinical practice across a variety of care settings (i.e. primary care, out-patient mental health settings) and with diverse patient populations.